DR. DAVID T JACOBS (NPI# 1811225394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811225394 |
| Entity Type | Individual |
| Full Name | DR. DAVID T JACOBS |
| Credential | MD |
| Practice Address |
24 Maple Ave Ste 2 Rockville Centre NY 11570-4259 |
| Mailing Address |
316 Edward Ave Woodmere NY 11598-2823 |
| Practice Telephone | 5168651234 |
| Mailing Telephone | 6468312744 |
| Enumeration Date | 2009-11-22 |
| Last Update Date | 2018-09-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | XXXXXXX | NY | Allopathic & Osteopathic Physicians |
| N | 2085P0229X |
Radiology Specialization: Pediatric Radiology |
257302 | NY | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
257302 | NY | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
257302 | NY | Allopathic & Osteopathic Physicians |
| Y | 202K00000X | Phlebology | 257302 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | NYS LICENSE | 257302 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952701468 | David Jacobs | Internal Medicine | 46 Timberhill Dr, Franklin Park, NJ 08823-1782 | 2014-09-03 |
| 1275944910 | David Robert Jacobs | Home Health Aide | 58 Juniper Cir, Florissant, CO 80816-9008 | 2014-05-15 |
| 1578753117 | David Marc Jacobs | Psychologist | 4476 Market St, Ventura, CA 93003-7775 | 2007-07-30 |
| 1386785988 | David M Jacobs | Chiropractor | 22 Wyckoff Ave, Waldwick, NJ 07463-1718 | 2007-02-08 |
| 1669531216 | David Jacobs | Urology | 1050 Lincoln Way, Mckeesport, PA 15132 | 2006-12-08 |
| 1205846342 | David Jay Jacobs | Physical Medicine & Rehabilitation | 554 White Oak Ridge Rd, Short Hills, NJ 07078-1338 | 2006-08-09 |
| 1609898154 | David Alan Jacobs | Counselor | 3900 Jermantown Rd Ste 200, Fairfax, VA 22030-4900 | 2006-07-24 |
| 1982668943 | David C Jacobs | Specialist/Technologist | 3605 Misty Morning Cir, Lexington, KY 40509-2065 | 2006-04-14 |
| 1154302537 | David Samuel Jacobs | Radiology | 300 Westage Business Ctr Dr, Suite 280, Fishkill, NY 12524-2260 | 2005-11-11 |
| 1437158185 | David Jacobs | Internal Medicine | 29355 Northwestern Hwy, Southfield, MI 48034-1053 | 2005-07-15 |
| Street Address |
24 MAPLE AVE STE 2 |
| City | ROCKVILLE CENTRE |
| State | NY |
| Zip Code | 11570-4259 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811462419 | Jessica Ilana Smuckler | Occupational Therapist | 90 S Park Ave Apt C2, Rockville Centre, NY 11570 | 2018-10-10 |
| 1356831309 | Pure Medical Services PC | Specialist | 2000 N Village Ave Ste 202, Rockville Centre, NY 11570 | 2018-05-15 |
| 1447766449 | Licura, LLC | Technician, Other | 566 Merrick Road, Suite 1, Rockville Centre, NY 11570 | 2017-12-28 |
| 1427505858 | Shera M Goodridge | Specialist | 134 Shellbank Place, Rockville Center, NY 11570 | 2016-09-01 |
| 1669830634 | Barbara Massina, Lcsw | Clinic/Center | 161 N Village Ave, Rockville Centre, NY 11570 | 2016-02-05 |
| 1972973428 | Medscript Pharmacy LLC | Pharmacy | 180-184 Sunrise Highway, Rockville Centre, NY 11570 | 2015-09-28 |
| 1265813703 | Jeffrey Michael Nozius | Registered Nurse | 1000 Hempstead Ave, Rockville Centre, NY 11570 | 2015-06-10 |
| 1568855971 | Meredith Kreinbihl | Counselor | 119 North Park Avenue, Suite 210, Rockville Centre, NY 11570 | 2015-03-09 |
| 1174921647 | Pamela Leake | Behavioral Analyst | 88 Hendrickson Ave, Rvc, NY 11570 | 2014-12-15 |
| 1467851584 | Lisa Brown-eisel, Lcsw, P.C. | Social Worker | 100 North Village Avenue, Suite 32, Rockville Centre, NY 11570 | 2014-08-14 |
| Find all providers in zip 11570 | ||||
| Taxonomy Code | 202K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Phlebology |
| Phlebology is the medical discipline that involves the diagnosis and treatment of venous disorders, including spider veins, varicose veins, chronic venous insufficiency, venous leg ulcers, congenital venous abnormalities, venous thromboembolism and other disorders of venous origin. A phlebologist has attained a minimum of 50 hours of CME units in phlebology-related courses, and is knowledgeable of and trained in a variety of diagnostic techniques including physical examination, venous imaging techniques such as duplex ultrasound, CT and MR, plethysmographic techniques and laboratory evaluation related to venous thromboembolism. The phlebologist is also trained in a variety of therapeutic interventions, which may include compression, sclerotherapy, cutaneous vascular laser, endovenous thermoablation procedures (laser and radiofrequency) endovenous chemical ablation, surgical procedures (e.g., ambulatory phlebectomy, venous ligation), vasoactive medications and the management of venous thromboembolism. |
| Notes: Source: American College of Phlebology 12/2006. www.phelbology.org [1/1/2007: new, 7/1/2009: definition reformatted] Additional Resources: Training Programs, Fellowships, and/or Preceptorships: Certification exam is being established by the American Board of Phlebology. ACGME Accredited Residency Program Requirements: None |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568096683 | Megan E Mosher | Phlebology | 74 Bunner St, Oswego, NY 13126-3357 | 2020-02-27 |
| 1356618615 | Varicose Vein Medical Office PC | Phlebology | 405 E Main St, Port Jefferson, NY 11777-1868 | 2011-11-30 |
| 1174753875 | Varicose Vein Medical Office PC | Phlebology | 405 E Main St, Port Jefferson, NY 11777-1868 | 2009-07-16 |
| 1851528434 | Ronald Lev Md, PC | Phlebology | 150 W 56th St, Suite #4403, New York, NY 10019-3822 | 2009-06-22 |
| 1578785341 | Ken Biegeleisen | Phlebology | 133 E 73rd St, New York, NY 10021-3556 | 2007-05-02 |
| City | ROCKVILLE CENTRE |
| Zip Code | 11570 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.